Provider Demographics
NPI:1831819036
Name:REGIMBAL, ASHLEY (APNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:REGIMBAL
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 LITTLE RIPLEY DR
Mailing Address - Street 2:
Mailing Address - City:SHELL LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54871-7707
Mailing Address - Country:US
Mailing Address - Phone:605-261-7144
Mailing Address - Fax:
Practice Address - Street 1:113 4TH AVE
Practice Address - Street 2:
Practice Address - City:SHELL LAKE
Practice Address - State:WI
Practice Address - Zip Code:54871-4457
Practice Address - Country:US
Practice Address - Phone:605-261-7144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12147-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily